Background

We conducted a systematic review to identify cases of infection-induced anti-myeloperoxidase (MPO) antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).

Methods

PubMed/Medline databases were searched from inception to July of 2020, according to PRISMA guidelines.

Results

Among the 618 abstracts identified, 18 articles describing 23 patients (60.9% female, mean age 50.5 years) were included. Median time between infection and vasculitis development was 3 months. Five (21.7%) patients expired during follow-up. Vasculitis regressed after the resolution of infection in 12/23 (52.2%). ANCA titers decreased significantly on follow-up in 14/16 patients and in all survivors in which they were measured. Pathogens reported included Mycobacterium spp., Coccidioides spp., Rickettsia rickettsii, Staphylococcus spp., EBV, CMV and Dengue virus.

Conclusions

MPO-AAV can occur after infection and may regress after its resolution. Infection should be considered in cases of MPO-AAV, as immunosuppressive treatment can have catastrophic results if the infection is not adequately treated.

中文翻译：

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感染诱导的髓过氧化物酶特异性抗中性粒细胞胞浆抗体（MPO-ANCA）相关性血管炎：系统评价。

背景

我们进行了系统的审查，以确定感染诱导的抗髓过氧化物酶（MPO）抗中性粒细胞胞浆抗体（ANCA）相关血管炎（AAV）的病例。

方法

根据PRISMA指南，从开始到2020年7月搜索PubMed / Medline数据库。

结果

在确定的618篇摘要中，包括18篇描述23例患者的文章（女性60.9％，平均年龄50.5岁）。从感染到血管炎发展的中位时间为3个月。随访期间有五名（21.7％）患者死亡。感染消退后，血管炎消退率为12/23（52.2％）。随访期间，在14/16名患者和所有接受过这项检查的幸存者中，ANCA滴度显着降低。报告的病原包括分枝杆菌属，球虫属，立克次氏菌，葡萄球菌，EBV，CMV和登革热病毒。

结论

MPO-AAV可以在感染后发生，并且在消退后可能会消退。对于MPO-AAV，应考虑感染，因为如果感染的治疗不充分，免疫抑制治疗可能会导致灾难性的结果。